Evidence map›Paper›PMID 33681676›Full record

ArticleHepatology communications2021

Effectiveness of a Decentralized Hub and Spoke Model for the Treatment of Hepatitis C Virus in a Federally Qualified Health Center.

Sarah A Rojas, Job G Godino, Adam Northrup, Maureen Khasira, Aaron Tam, Lisa Asmus, Catherine Frenette, Christian B Ramers

Open access · goldAbstract read
In one paragraph

Article in Hepatology communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
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  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Sarah A RojasLaura Rodriguez Research InstituteFamily Health Centers of San DiegoSan DiegoCA.ORCID 0000-0003-0268-1682
Job G GodinoLaura Rodriguez Research InstituteFamily Health Centers of San DiegoSan DiegoCA.ORCID 0000-0002-4852-6277
Adam NorthrupLaura Rodriguez Research InstituteFamily Health Centers of San DiegoSan DiegoCA.ORCID 0000-0002-9877-333
Maureen KhasiraLaura Rodriguez Research InstituteFamily Health Centers of San DiegoSan DiegoCA.
Aaron TamLaura Rodriguez Research InstituteFamily Health Centers of San DiegoSan DiegoCA.
Lisa AsmusInstitute of Public HealthSan Diego State University Research FoundationSan DiegoCA.
Catherine FrenetteDepartment of Organ TransplantScripps ClinicLa JollaCA.ORCID 0000-0002-2245-8173
Christian B RamersLaura Rodriguez Research InstituteFamily Health Centers of San DiegoSan DiegoCA.ORCID 0000-0003-2419-2054
Family Health Centers of San Diego · USSan Diego State University · USUniversity of California San Diego · USScripps Clinic · US

Funding

The Hepatitis Care Connection Program (Hep-Care Connect)U51PS003924 · PS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI WYLES, DAVID L · 2012 to 2013
$1.8M
NCHHSTP CDC HHS U51 PS003924
6 · The paper itself

Abstract

Hepatitis C virus (HCV) is a major cause of cirrhosis, liver cancer, and mortality in the United States. We assessed the effectiveness of decentralized HCV treatment delivered by nurse practitioners (NPs), primary care physicians (PMDs), or an infectious disease physician (ID MD) using direct-acting antivirals in a Federally Qualified Health Center (FQHC) in urban San Diego, CA. We conducted a cross-sectional analysis of 1,261 patients who received treatment from six NPs, 10 PMDs, and one ID MD practicing in 10 clinics between January 2014 and January 2020. Care was delivered based on the Extension for Community Healthcare Outcomes (Project ECHO) model with one hub and nine spokes. HCV was deemed cured if a patient had a sustained virologic response (SVR) after 12 weeks of treatment (SVR12). We evaluated differences in the prevalence of cure between provider types and hub or spoke status using Poisson regression. Patients were 34% Latino, 16% black, 63% were aged >50 years, and 59% were homeless; 53% had advanced fibrosis, 69% had genotype 1, and 5% were coinfected with human immunodeficiency virus. A total of 943 patients achieved SVR12 (96% per protocol and 73% intention to treat). Even after adjustment for demographics, resources, and disease characteristics, the prevalence of cure did not differ between the ID MD and PMDs (prevalence ratio [PR], 1.00; 95% confidence interval [CI], 0.95-1.04) or NPs (PR, 1.01; 95% CI, 0.96-1.05). Similarly, there were no differences between the hub and spokes (PR, 1.01; 95% CI, 0.98-1.04).

Indexed as

Models, OrganizationalAntiviral AgentsCaliforniaCohort StudiesCommunity Health CentersCross-Sectional StudiesFinancing, GovernmentHepacivirusHepatitis CHumansIll-Housed PersonsIntention to Treat AnalysisPatient Acceptance of Health CarePoisson DistributionPractice Patterns, Physicians'Sustained Virologic ResponseAntiviral Agents

Identifiers

PMID33681676
PMCPMC7917265
OpenAlexW3117815803

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.